Postpartum depression

Postpartum depression
Other namesPostnatal depression
Postpartum Depression Venus, a representation of the loss and emptiness felt after childbirth
SpecialtyPsychiatry
SymptomsExtreme sadness, low energy, anxiety, changes in sleeping or eating patterns, crying episodes, irritability[1]
Usual onsetA week to a month after childbirth[1]
CausesUnclear[1]
Risk factorsPrior postpartum depression, bipolar disorder, family history of depression, psychological stress, complications of childbirth, lack of support, drug use disorder[1]
Diagnostic methodBased on symptoms[2]
Differential diagnosisBaby blues[1]
TreatmentCounselling, medications[2]
Frequency~15% of births[1]

Postpartum depression (PPD), also called postnatal depression, is a mood disorder experienced after childbirth, which can affect men and women.[3] Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns.[1] PPD can also negatively affect the newborn child.[4][2]

While the exact cause of PPD is unclear, the cause is believed to be a combination of physical, emotional, genetic, and social factors.[1][5] These may include factors such as hormonal changes and sleep deprivation.[1][6] Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder.[1] Diagnosis is based on a person's symptoms.[2] While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.[1]

Among those at risk, providing psychosocial support may be protective in preventing PPD.[7] This may include community support such as food, household chores, mother care, and companionship.[8] Treatment for PPD may include counseling or medications.[2] Types of counseling that are effective include interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychodynamic therapy.[2] Tentative evidence supports the use of selective serotonin reuptake inhibitors (SSRIs).[2]

Postpartum depression affects roughly 8.9 to 10.1% of women in high-income countries and 17.8 to 19.7% of women in low and middle-income countries.[9] Postpartum depression commonly affects mothers who have experienced stillbirth, live in urban areas and adolescent mothers.[10] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[3] Postpartum psychosis, a more severe form of postpartum mood disorder, occurs in about 1 to 2 per 1,000 women following childbirth.[11] Postpartum psychosis is one of the leading causes of the murder of children less than one year of age, which occurs in about 8 per 100,000 births in the United States.[12]

  1. ^ a b c d e f g h i j k "Postpartum Depression Facts". NIMH. Archived from the original on 21 June 2017. Retrieved 11 June 2017.
  2. ^ a b c d e f g Pearlstein T, Howard M, Salisbury A, Zlotnick C (April 2009). "Postpartum depression". American Journal of Obstetrics and Gynecology. 200 (4): 357–364. doi:10.1016/j.ajog.2008.11.033. PMC 3918890. PMID 19318144.
  3. ^ a b Cite error: The named reference Paulson_2010 was invoked but never defined (see the help page).
  4. ^ Grace SL, Evindar A, Stewart DE (November 2003). "The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature". Archives of Women's Mental Health. 6 (4): 263–274. doi:10.1007/s00737-003-0024-6. PMID 14628179. S2CID 20966469.
  5. ^ Stewart DE, Vigod SN (January 2019). "Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics". Annual Review of Medicine. 70 (1): 183–196. doi:10.1146/annurev-med-041217-011106. PMID 30691372. S2CID 59341428.
  6. ^ Soares CN, Zitek B (July 2008). "Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability?". Journal of Psychiatry & Neuroscience. 33 (4): 331–343. PMC 2440795. PMID 18592034.
  7. ^ "Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes". Agency for Health Care Research and Quality. Archived from the original on 11 November 2013.
  8. ^ Dennis CL, Fung K, Grigoriadis S, Robinson GE, Romans S, Ross L (July 2007). "Traditional postpartum practices and rituals: a qualitative systematic review". Women's Health. 3 (4): 487–502. doi:10.2217/17455057.3.4.487. PMID 19804024.
  9. ^ Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG (September 2017). "A systematic review and meta-regression of the prevalence and incidence of perinatal depression". Journal of Affective Disorders. 219: 86–92. doi:10.1016/j.jad.2017.05.003. PMID 28531848.
  10. ^ Carlson K, Mughal S, Azhar Y (2023). "Postpartum Depression". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 30085612. Retrieved 18 September 2023.
  11. ^ Seyfried LS, Marcus SM (August 2003). "Postpartum mood disorders". International Review of Psychiatry. 15 (3): 231–242. doi:10.1080/09540260305196. PMID 15276962.
  12. ^ Spinelli MG (September 2004). "Maternal infanticide associated with mental illness: prevention and the promise of saved lives". The American Journal of Psychiatry. 161 (9): 1548–1557. doi:10.1176/appi.ajp.161.9.1548. PMID 15337641. S2CID 35255623.